overdiagnose & overmedicated?
ADHD – the four letters that are enough to strike terror into the hearts of most parents. After all, the condition is thought to affect one in ten children, mostly boys, leading to poor academic achievement, social isolation and unhappy kids. But “fear is a toothless dog” goes the saying, and you only need to take a peek inside the jaw to feel relief. So let’s look inside the jaws of attention deficit and hyperactivity disorder (ADHD), and see if the stigma can be lessened once we have investigated the ins and outs of this misunderstood, routinely overdiagnosed, often mismanaged – and yet treatable – condition.
what is it?
Psychiatrists use their Diagnostic and Statistical Manual (DSM) to help them classify and diagnose mental illnesses and conditions. In the fifth edition of the DSM, ADHD can be diagnosed if children show six of the following symptoms, from either or both the inattention and the hyperactivity and impulsivity criteria, by the time they are 12 years old:
inattention An abnormally short concentration span.
A frequent resistance to sustained mental effort, especially with boring or repetitive tasks.
Easily distracted. Marked forgetfulness. A tendency to lose things easily and frequently.
Difficulty organising tasks and poor planning.
Not listening properly to given instructions.
A tendency to rush work, giving poor attention to detail and making frequent but careless mistakes.
Often not completing tasks.
hyperactivity Constantly on the go, as if driven by a motor.
Runs about or climbs on things excessively.
Restless, unable to stay seated for even short periods. Fidgets excessively. Excessively talkative. Plays loudly.
impulsivity Often interrupts or intrudes on others. Cannot wait his turn. Blurts out answers before the question is completed.
It is quite normal to display “first year medical student” syndrome and diagnose your child on the spot as you read this list, especially with vague-sounding symptoms such as these. All children do display these behaviours, age appropriately, from time to time. So bear in mind that these symptoms must cause significant impairment to your child’s daily functioning, and must not be better explained by another mental disorder – which is important when you consider 40 percent of boys with ADHD also have oppositional defiant disorder (a persistent pattern of rebellious behaviour).
Children with ADHD are impaired in their schoolwork as well as in their social functioning, and are distressed and demoralised. Still, judging these symptoms is